Body

Liposuction

Liposuction removes fat from underneath the skin. First a small incision is made, about the width of a staple. Through this incision, fluid containing a numbing medication (lidocaine) and epinephrine is infused into the layer of fat beneath the skin. The lidocaine minimizes pain after the operation, and the epinephrine helps prevent bruising. The fluid also helps to break up the fat. A blunt metal tube is then used to remove the fat.

Dr. Greer performs liposuction both under general anesthesia, and on patients who are awake. Having liposuction while awakes gives you the benefit of no recovery from anesthesia medications, with only minimal discomfort during the procedure itself.

What areas of the body can liposuction be done on?

Liposuction is done most commonly on the abdomen, hips and waist, but it can be done on many other areas of the body, including:

Under the chin

The upper arms

The upper back under the bra roll

Over the chest in men

The inner thigh

The outer thigh

The knee

What happens if I gain weight?

When you gain weight, the fat cells you have fill up with fat. When you lose weight, these fat cells deflate. But the overall number of fat cells you have is fairly constant, although they will multiply after large increases in weight. Liposuction removes the fat cells themselves, not just the fat inside them. So if you gain weight after having liposuction, you will likely gain it in other areas of the body.

What is the recovery like after liposuction?

As with any operation, your recovery will be unique to you. Everyone has a different pain tolerance and recovers at a different rate. That being said, the recovery from liposuction is generally very tolerable.

Pain is usually less than with an abdominoplasty, C-section, or other types of surgery that go through the muscle layer. You’ll likely have moderate pain the first one to two days after surgery, and then you’ll experience discomfort or soreness rather than true pain. Most patients take narcotic pain medication for the first couple of days, and then transition over to ibuprofen or Tylenol within a few days after surgery.

You will have a large amount of drainage from your incisions over the first 24-48 hours. This will taper off and stop by day two after surgery. This fluid is the numbing fluid which is used to break up the fat during liposuction. It is tinged with blood, so it is usually pink or red.

Liposuction also causes quite a bit of swelling and bruising. The bruising fades within a couple of weeks, but you will have to wear a compression garment for up to three months after surgery to help the swelling resolve.

If you are considering having liposuction, be prepared to take from several days up to a week off work, depending on how physically active your job is. Walking and light exercise are fine after the first week, but do avoid any heavy cardio (e.g. running) or weightlifting for a full month after surgery.

Abdominoplasty (tummy tuck)

What is an abdominoplasty?

Tummy tuck, or abdominoplasty, is an operation done to flatten the tummy. There are two main components:

Removal of excess skin – The skin from just above the belly-button (umbilicus) down to the level of the bikini line is removed. The belly-button is left in place, and a new hole is made for it in the skin that is pulled down. This results in a scar at the level of the bikini line stretching from hip to hip, and another scar around the umbilicus itself.

Realignment of the abdominal muscles – The rectus abdominis muscles travel in two parallel lines down the abdomen. These are the muscles that form a 6-pack. The space between them is composed of fascia, a tough connective tissue. If the abdominal wall is stretched out, as happens with pregnancy, this fascia stretches and allows the two muscles to move farther apart. The fascia may rebound after pregnancy, allowing the muscles to heal in their anatomic (i.e. normal) position. If it stays stretched, this is called a rectus diastasis (the word diastasis means widening). The second goal of abdominoplasty is to repair this widening. This is done by suturing the two muscles closer together, resulting in a flatter tummy and more defined waistline.

Labiaplasty

What is labiaplasty?

Labiaplasty is done to reduce the size of the labia minora, which are the hairless inner lips of the genitalia. The hair-bearing outer lips are called the labia majora, and the hair-bearing skin over the pubic bone is called the mons (meaning hill or mound). Labiaplasty is done to alleviate symptoms such as tugging and twisting of the labia during physical activity or during intercourse, and to achieve a more normal appearance.

Labiaplasty can be done under local anesthesia with oral pain medication, or under general anesthesia. Surgery is done as an outpatient, and you will have some swelling and bruising in the postoperative period. Using ice packs for 20 minutes every hour and lying with your bottom elevated on a pillow will help decrease swelling and pain. Most patients take a week off work. You will need to wait until six weeks after surgery to resume exercise, wearing tampons, and sexual intercourse. Although most of the swelling will be gone at six weeks, it may take up to six months to resolve completely.

Monsplasty

What is a monsplasty?

The pubic mons is the hair-bearing skin over the pubic bone. After pregnancy, weight gain, or weight loss, the mons may become ptotic (saggy) or appear puffy from excess fat. A monsplasty is done to flatten and lift the mons, making the area less noticeable in clothing.

A monsplasty may involve liposuction to remove fat, excision of excess skin, or a combination of the two. Surgery is done as an outpatient, and can be done under local anesthesia with oral pain medication, or under general anesthesia. Bruising and swelling are common postoperatively, and can take several weeks to resolve completely. Most patients need anywhere from a few days up to a week off work to recover.

Brachioplasty (arm lift)

What is a Mini-Brachioplasty?

An arm lift, or brachioplasty, is an operation to remove excess skin over the upper arm. This is commonly done after weight loss, but may also be done to remove the “bat wings” that develop in aging arm skin. In a traditional brachioplasty, excess skin is removed along the entire length of the upper arm (see the area marked out in blue on the diagram below).

This results in a scar which is very noticeable. Not only does it run down the back or inside of the entire upper arm, but scars in this area tend to widen and thicken as well. Some patients are turning toward a mini-brachioplasty to avoid this significant scar. In a mini-brachioplasty the incision is horizontally oriented along the edge of the underarm area, making it much less visible. This is only able to remove excess skin from the proximal part of the upper arm, right near the underarm (the area marked in green on the diagram). The mini-brachioplasty may also be combined with liposuction to address excess fat further down the upper arm. Not everyone is a candidate for the mini procedure, however, as it only addresses excess skin over the upper ⅓ of the arm. If there is excess skin along the entire upper arm, a traditional brachioplasty would still be needed.

Surgery after massive weight loss

Skin Removal Surgery

Excess skin is very common after losing a large amount of weight. It may develop over the abdomen, lower back and buttocks, upper arms, and thighs. Surgery is really the only effective way to remove excess skin. There are some non-invasive treatments out there, but most of these are geared toward smaller surface area (e.g. along the jawline), and show minimal improvement at best. Surgery may be done:

Over the upper arms (brachioplasty)

Over the thighs (thigh lift)

To lift the breasts (mastopexy)

To remove skin from the abdomen

Read more about body contouring at the website of the American Society of Plastic Surgeons.

Before and After Photos***

***All patient results may vary, these procedures are for cosmetic purposes only and results are not guaranteed, nor are permanent. All patients are different and in no way will any procedures be alike, nor the recovery period.

Greer Plastic Surgery

As a wife and mother, Dr. Greer understands what it's like to check traffic in your rear-view mirror and notice the new lines around your eyes. Or to love your children dearly, but miss the body you had before kids.